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Serving Over 20,000 US Medical Transcriptionists

IC working for a small rural hospital

Posted By: Tia on 2005-11-15
In Reply to: believe me they are...:) nm - gto

I have worked for a small rural hospital as an IC for 9 years, this year I asked for a raise.  Hospital thought about going to a national until they found out how much they charged.  They contract their transcription themselves.


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Opinions please! I have been asked by a small rural hospital to do their overflow. SM

It is clinic notes that are pretty easy to type.  Some of the work is digital and some is still on tapes.  They want me to come in and pick up tapes, and they want me to print and deliver reports when I pick up the tapes because they don't know much about setting up a remote printer.  I made an introductory offer of 12 cpl for the first month and then 15 cpl if we both feel like continuing to work together.  I felt that since I am going to be out the cost of gas and ink, my offer was more than reasonable.  Well, they countered with a flat 12 cpl period with a one year contract and then we reevaluate at that time.  While I was mulling that over, she called back and asked if I would be interested in doing some radiology for them in addition to the clinic work.  So basically this account will keep me very busy and is not going to be just overflow.


So now I'm back to thinking 15 cpl and because they balking, not offering the introductory rate anymore.


What does everyone think?


Depends on what kind of hospital? Large urban hospital or small community hospital? SM

Also, is it a large teaching hospital? If so you have to consider there will be A LOT of different residents dictating, usually a lot of ESLs at teaching hospitals, and the residents rotate out and new ones rotate in every summer. So you can't expect to get the same dictators and build up your macros because the dictators change all the time.


I would say 9 cpl would be a pretty good offer for a small to medium community hospital where you will be doing the same dictators on a daily basis.  But for bigger, urban or teaching hospitals I would want at least 12 to 15 cpl. 


In 1995 I was making 12 cpl for a small, rural

Changes were gradual.  First, we were allowed to start working at home at 12 cpl, instead of the hourly wage.  We still were employees and had the same benefits.  This saved the hospital money in overhead and we were all happy.  Then they started using outsourcing services for holidays and weekends.  Gradually, the whole MT dept was phased out and we had the option of going with the service handling the hospital transcription or finding another job.  The service kept us at this rate of pay for a short time and then gradually started implementing "incentive bonuses" and lowering the line rate of pay.  It evolved over the years to what it is today.  Starting line rates were lower and incentive bonuses done away with.  Health insurance is contingent on production, but their platforms crash regularly (as do many, many others) and we either have to work extra to make up the loss or just eat the financial loss altogether.  The services overhire to make sure that their TAT is met, which means unstable availability of work, which in turn affects production, in turn affecting benefits. 


The logic today behind all the changes is the "lack of experienced MTs in the U.S.", thus the need to hire people outside the country, who have even LESS experience with the English language and slang medical terms, at half the price of hiring American MTs.  The MT field in general has to be able to compete and so must lower their rates to keep clients from going offshore at half price.  And now with the advent of VR, the MTSOs using it try to justify the cut in line rate to the fact that we're no longer "typing", we're "just editing."  It's been a gradual evolution, but not in a positive direction.


And in all of this, AAMT has not come to the aid of the transcriptionist.  It has furthered the promotion of offshoring and has developed ways to enhance the MTs adjustment to VR instead of enhancing the MTs value and amount of worked involved in VR.  When the AAMT doesn't step up for the very ones it says it represents, why would the ones using the services respect, understand, or value the MT either?  


I'm an IC for a mid south rural hospital...
Although I get paid per minute of dictation, I have done the math and I make 10-11 cents per line.  Patti is right, it doesn't matter per line or per minute.  Its what you make per hour.  I do radiology and the basic four every day with the same dictators with a new one thrown in every now and then and have been doing so for 13 years and make anywhere from $20-35 an hour working average 5-6 hours a day.  Did not ask for a rate increase until my 8th year in which they balked at and began looking elsewhere.  Two years later asked for another rate increase in which they readily agreed to but keep better track of what I do.  Better to start low and become valuable to them than start too high.
I live in a small rural area and they housed some evacuees at a nearby military base
crime went UP in our little community that previously HAD a ~very low~ crime rate. It is a FACT. I'm not saying all NO residents are like that, but MANY seem to be.

My mom was raised in conditions like this poster describes. Mom's parents died when she was 7 (father) and 9 (mother). Her teenage sister (newlywed) raised her and 4 other siblings. They had next to nothing. Not ONE of them turned to a life of crime. Not ONE even graduated high school but they still made good lives for themselves. Life was rough for them, but they didn't blame it on everyone else and cry around about what the president should be doing for them. It is all about RESPONSIBILITY and taking what life throws your way. IMO.
small hospital
I get 12 cpl as an IC for a hospital. No pickup, delivery, or printing. All work is internet based. Not only is gas expensive, but have you seen the price of printer ink lately? I would stand firm on the 15 cpl.
On-call transcription in a small hospital

I work for a very small rural hospital with only two full-time transcriptionists and one part-time transcriptionist.  We have recently been told that the administration of our hospital is entertaining the idea of on-call Transcriptionist for uncovered hours.  We already work alternating Saturdays (day shift only).  I wanted to know if any other hospitals out there do on-call transcription (Not from home and not outsourced).  They want us to physically drive in and be in the office to do this transcription.  Any information at all would be greatly appreciated.  Thanks. 


working IN A HOSPITAL is different than working at home.
Someone can steal you identity from the internet if they want to. Why would you go to the time and trouble to jeopardize a job that requires some level of skill to steal someone's identity or medical records? You could get a job as a retail clerk and get info easier than going through the testing required to become an MT.
The down side of working for a small
things stating "you get paid when we get paid by the client".  WRONG!!  Stay away from these types!!!  That is a wrong practice and should not be passed on to the subcontractors.  I hope you get your $$$!!!  Jerks like this give all small companies a bad name.  As if your bills aren't as important or the time you spent transcribing is not worth the effort to make a timely payment!!!!  
Would be interested in working for small MTSo
I currently am working with a small co and I would like approx 15-20 more hours of work. I mainly do clinic. If you have anything please let me know. I love small MTSOs
Usually only if working for a VA Hospital but
it really depends on the company. I don't think many do background checks otherwise. What they look for is schooling and experience and work history.
If you have been working for a hospital and SM
never a national before, to be really blunt and I don't really want to be, but you won't know what hit you. You will be truly stunned at how underhanded big business is. You think you know, but you don't, until it happens to you.

I wish I had something positive to say. If I did, I might say simply to find another line of work. When you go to work for Spheris or any other national company, you are in for a shock.
MT working at home for hospital
I just recently was sent home from a local hospital where I work. I make $15.80/hour, no incentive, and we are required to type a minimum of 1200 lines per 8-hour shift.
18 cpl straight from a hospital working at home. nm
x
Question about working on Hospital accounts
I have over 5 years of experience unfortunately it is all clinic experience. Are there any companies that will hire a Transcriptionist with this much experience but not in the Acute Care field? I really would like to start doing those types of transcription. Any advice would be appreciated.

Thank you.
Now that I'm back working directly for the hospital
nm
Key words: Utah and Hospital. Different from working at home and different SM
from working in a state that has low tolerance for drinking.
Try working inhouse at a local clinic or hospital.
That's what many MTs end up having to do to get their foot in the door & gain experience. IMO, that's the best way to start anyway since you have experienced people nearby to ask for help because those first few months can be very difficult. Good luck!

P.S. Agree with the other posters below that you need to specify you have your certificate in MT, not referring to yourself as a Certified MT which is a completely different thing and can only be obtained after a few years of experience & testing with AHDI. However, that brings up another topic... many MTs choose not to become certified now that AHDI has sold us out & encourages offshoring of our work. I've been doing this nearly 20 years and only once have ever been asked if I had my CMT, so it's pretty much irrelevant anyway. As long as you have experience & test well, that's what they care about.
If you are working at an hourly rate in a hospital setting, then you are
going to be in for a shock when you go to production rates. Most of the in-house positions were farmed out years ago. If you were lucky to secure an in-house position for this long, consider yourself blessed.
$15,000.... Hospital employee, telecommuting from home, working less than full-time.
c
I'm a hospital employee, working local at home, so I get a raise every year.
x
I have 13 years experience and just started a hospital job working from home making $16 an hour

and with a really good incentive plan.  I live in the Kansas City area.  $10 seems like a low starting point even with only two years experience which is the usual benchmark for hospital MT jobs. 


It's been my experience that the low end of the pay scale for hospital employed MTs was around $12 an hour.  Also, it's been my experience that the pay offered is usually based on years of experience and how well you perform on the transcription test.


I would say if their pay is that low, they should at least be making it up with incentive and it doesn't sound like they are.


JMO


Working full time at home with small children is hard but part time works great
is almost impossible. You will either have to work when your spouse is home or for only a few hours during the day and then more when they are asleep. I work part time at home and my kids (2&5 now) have done very, very well. They are great kids, very well behaved, don't get into much. I stop working to check on them/give them some attention every hour or so while I work (5 hours each afternoon or so) and they get all my attention in the morning and at night. It has worked out beautifully for us.
Or after a boring weekend when working at a hospital someone asks "How was your weekend?" and

small mentality usually means small pocketbook
Still make more than you and I but that is deserved. They've put the effort forward and educated themselves.


I worked for a rural doc. So much fun! :)

We even had a patient in the waiting room one day that brought in a paper bag with baby chickens in it as it was too hot to leave them in the car.  Nobody in the waiting room gave it a second thought.


It was great fun to work there.  They called it a "medical center" but it was in an old house with less than state of the art equipment.  The country folk swore by "Doc" and "Doc" didn't think twice about going out at 3:00 a.m. to make a house call.


He never would have dreamed of asking for a co-pay up front and even let one farmer's wife pay with fresh baked pies.


They sure don't make them like they used to.


P.S.  We still had typewriters back in 1994.  :)


I have the same problem and we are not THAT rural....sm

It is very frustrating to feel so limited in your job choice b/c of something like that.  I have never really had any major problems with my dial-up and have been told by two different techs. that I have excellent connection speed considering it is dial-up.  Frustrating though....


rural hospitals
If this is an extra job I would certainly make it worth my while. I worked at small hosp. for 5 yrs that did not want to work us from home. Kept saying they could not but I knew better. Eventually I went off on my own and have been home since. We had 3 FT. They hired 2 in my place and 1 PT for wknds. I type at night now to catch them up. They still had 1 PT and 4 FT, but I charge them 15 cpl. I clear in 5-8 hours what they all 4 do in 1 day, literally. Still did not want to put me or others at home. Want me to drive 45 miles 1 way to type, after I've pulled my reg. 8. Now what I do, whether they know it or not, I dial up on my C-phone into thier system and type at home, save it to disc (they monitor email + HIPPA) drive over for about an hour and transfer work into thier system. So if they have a phone in line you might check with them about on call stuff being typed at home, especially if this is stat work. It will certainly get back to them quicker. This is just fear of the unknown. This same hosp. has now, instead of firing those not doing work and hiring a good worker or paying them OT will pay me double the amount. They have also moved the weekend girl to FT and are letting a file clerk/PT IC do the weekend x-rays and still want me to help. That's 5 full time typist and 2 PT for a 43 bed hosp. Thier may reason was not to put thier network on home computers, which they all ready do. Won't give me network access but have given it to the weekend girl. Plus they are paying a consultant out the wazoo to tell them why this is not working!

If you are going to be on call, make sure you have set days or hours that you will be on call and that you are compensated. Don't let them just pay you for the work you do. Your time is worth money also. In other words don't sit home all day 3 nights a week waiting for a phone call and get paid for 1 hours. I have done this in the past where I worked and was on call on weekends for x-rays. There might be 1 or 21 or none. I got paid by the hour. If there were none I got paid for 1 hour for showing up. Ask an x-ray tech or someone who gets on call pay. They get a flat rate for being on call and then they get paid for the individual call.
Actually, I live in a rural community sm
and left a hospital where that was very good pay.  Starting wages for MT was $8.00 an hour with a 25 cent raise every year if you were lucky.  $11.50 would be like gold for the transcriptionists that work there.
Just moved to a rural area
Have a satellite dish, no cable.  The phone company out here does not provide ULD.  One job I would like you need ULD, and the other you need internet access, no satellites accepted.  Does anyone have any ideas?  Is there a way you can get even dialup without having to use long distance?
Rural America wages
Last year interviewed for two transcription jobs. Neurology office $13.50, hospital $16.00. (the most I have ever been offered) I was offered the neurology position, but declined and the hospital job was given to someone with less experience, i.e. less $$$, they were hoping to add an addition MT on, but did not. I have over 15 years multispeciality office transcription experience including running my own business for 10+ years. I basically learned on the job, sort of fell into transcribing 20 years ago. I am also a Certified Medical Assistant (silly me, actually went to school for that), I have worked in physicians office over the past 20 years part-time doing medical assisting and transcribing and worked my way up to $11.50/hr. Unfortunately in the office MAs are being replaced by regular high-school graduates, $7.00 per hour, etc, and of course they can do transcription too.. ha ha. Since I live in a rural area the opportunities are limited and each position would require a lengthy commute and with high gas prices that is just crazy, so I decided to go employee with national. Since I get paid by production I can make more $$$ that way overall but the cpl rate is not nearly what it should be, you just keep working harder for the $$$. I would not recommend anyone get into this field by choice as technology will eventually whittle us away to almost nothing. If you want medical, go for the top.. doctor, RN, nurse practitioner, PA, etc. Decent wage and some respect, too.
Rural doctor situation...

I hate going to the doctors office.  My daughter has had a sore throat for a week and went in to see doctor this morning, sat there for three hours.  We have gone through six different pediatricians/primary doctors in 11 years.  How are they suppose to know if there is something really wrong.   Doctor looked at her (daughter, 17)  throat and asked why she had not had her tonsils out.  Did not ask her history.  She has not had a throat infection in over 10 years.  As a toddler she had frequent throat infections and naturally large tonsils and doctors never once stated they should come out.  Now, she is worried.  She is a vocalist and does not want to that to effect her singing.  Anyway, I'm getting off the subject here.  We went in to see the doctor in clinic to find out he quit Friday and there is an interim doctor (who we've seen in ER and who has filled in for other M.D. in the past and like a lot better than current M.D.  Too bad he is not staying).  Is it that inconvenient for doctors to locate a practice in a rural area? Our area might not have much but we are only 30 minutes away from one medium city and 45 minutes away from a moderate one.  Our little town is now down to one doctor when at one time it had 4-5 family practices.  We have a hospital, but no doctors.  LOL.   


Thanks for letting me vent, but this is really getting riduculous.  The doctor today did inform me that he was trying to recruit either some doctors finishing their residency or maybe some middle aged doctor from the N.O. area that would like to start over.  We have great facilities, just no doctors.


I give, where in rural Georgia
are you talking about? I think I could put up hearing that more than I can with what I hear out of the Atlanta stations, at least it is not butchering the English language - just maybe their own language like I had mine from moving from Tenn. I understand that nexted above- I have heard that and even worse. I have a daughter-in-law who is parapro right outside of Atlanta (Jonesboro) and supposedly they are not to correct children when they speak incorrectly- she says heck with that and does. Can we say ebonics?
I'm not in a rural area. I'm in a big city and everything is SM
outsourced. My beloved company, run by a very decent man, was bought out by Edix. I thought they were bad until Spheris took them over. God help us.

Then there is the large community hospital, who has a "sweetheart deal" with another outsource company. You would not believe the garbage that goes on in this field.
Regarding unlocked doors, rural or not
My sister once left this true-crime book at my house and I read it, I guess because I wanted to have nightmares for a week.  It was about serial rapists (WHY does she read this stuff?)  Anyway.... one thing I noticed was that almost ALL of these perps walked into people's houses thru their unlocked doors, usually in the middle of the day.  Sure your husband may be right about if someone wants in they'll get it, but just like anyone else, criminals prefer to do things the easy way.  Why help them? 
It is pretty rural where I am too, but the sprawl is coming - sm
My friends in the area (been here 8 years now) are people from the old school my kids went to, now a couple parents at the new PS they are going to and my neighbors. I am lucky in that I live on a private road with 14 houses on it. It is our own little world/community and we all get together now and then and have about 2 big parties a year (Daytona and 4th of July). I am close friends with one neighbor. I don't really have a "best" friend here (they are back home where I grew up in PA who I see 3-4 x a year) that I go shopping, etc. with, though Mary and I do things now and then with our kids. See if you can get friendly with your neighbors, good to have a local support system in place if you need it. Maybe a local library or club. Our area is slowly building up, have a supermarket now 5 minutes away versus 30, a local library, 2 dance studios, martial arts, a couple restaurants, Curves, movie store, etc. Try to get involved in some local club or activity, great way to meet people, or voluteer down at your local elementary school 1 day a week or something, they can always use some help. I keep very busy with work, Curves, taking the kids to dance (there are adult classes too), library trips in the summer, etc. I am pretty social though I don't mind being by myself either; so I try to keep a happy medium, but getting out and involved in something is the key to meeting new people. Give it a shot.
Do you think a company pays less for rural pay than city?
Does not make sense to me.
I am am in a rural area with lots of trees - sm
so when I had Bluesky (or what ever the name it) come out they said too many trees for the satellite. My one neighbor just got Directv high speed.....she also has lots of trees. So I may be looking into that (have Directv now just not the internet hookup). But I currently use a Sierra Wireless Aircard 875U. Unlimited and costs me $67 a month. It is through AT&T but I know Verizon has it too, as well as Sprint. You need to make sure it works where you are first though, but their websites can help you there. I love it. Not as fast as DSL but a huge step up from dial-up. I have it set up to use on my desktop, laptop, my backup desktop, and my daughter's computer. The only thing I have with it is it does not work everywhere...when I try to use it on my laptop...unlike the commercial where they show the guy in the middle of Africa or wherever he is. But I have been very happy with it.
I worked in a rural physician's practice for years.
He eventually ended up joining a group.  He still has his office in the same place, but is financially part of that group.  Unless they join some sort of group/organization so that they can get group rates on lab, insurance, etc., it is really hard for them to survive.  The community lost its hospital several years ago.  You said your community has a hospital, but is it a full-service one?  Our next nearest town with a hospital is about 35 minutes away.  Now the 2 hospitals in that town each have satellite physician clinics in our little town.  When I was working for this physician, we had a total of 4 doctors in town.  Now, through these satellite clinics, we have a good number.  Before this physician joined this group he recruited numerous physicians over the years.  Unfortunately, he was not able to assure them enough of a salary and benefits to keep them.  There is simply not enough money coming into these small clinics.  They have to satisfy Medicare and insurance regulations, just like the big clinics.  The recruited physicians all eventually left for greener pastures after being actively recruited by other facilities.  One physician I remember tripled his salary when he left there. 
just some information for MTs in rural areas where high speed is not available

Hi all,


Was just on the Sprint website a little bit ago and checking out wireless cards for my laptop since I will be moving to an area that doesn't even have landline service available yet.  Sprint is now offering a wireless card that is a USB card and apparently will work with both a laptop and a desktop as long as you have an available USB port on your computer.  Might be something to think about


 


Yep, I agree 100%. I live in such a rural area, though, that my neighbors, the natives, think I'm
NUTS cause I keep my dogs in the house, and actually still walk them on a leash in my yard.  We all have about 2 - 5 acres minimum each of woods in our neighborhood, and no real dog laws at all! Dogs run at large 24/7, which is no picnic for me with my dogs on leash, either!  And they ALL keep them outdoors, tied up with the chain and the smelly old dog house.  I think they just look at dogs strictly as deterents? Not sure really, come to think of it! Cause even if they were getting robbed, Fido couldn't get off the 6 foot chain! Oh well!  I used to be sad all the time for the plot of the dogs here, but I can't save them all! Only my guys!
You must live in a metro area because rural areas pay even less per hour.

Of course you can buy a big house for 130,000 in a smaller town and the same amount won't buy you a pot to pee in, in a place like San Diego or the D.C. area.  It's all relative.


The phone line has to support DSL signals. Most rural lines don't due to distance from central of
x
You get more working the evening or night shifts and working w/o benefits. And producing like a mad
,
Ditto....granted I am not working much these days, but am currently trying out a new way of working
when I do work which seems to be helping.  I am timing myself and keeping a log of how long it takes to to type however many minutes.  I am averaging anywhere from 13-18 minutes of dictation an hour now doing this.  Granted the time fluctuates between who I am typing, and if I have to look up names, addresses, etc., just depends on the division I am doing at the time.  But work that used to take me 3 hours to do is now taking me under 2 hours, I am also trying to put in more macros as I go along, which slows me down initially but pays off in the long run of course.  I was working "all the time" before but took forever to get done since I was not applying myself. This new "attitude" has helped me a lot.  My goal, in the Fall, is to do 90 minutes a day consistently at 6 hours, and then maybe get up to 120 minutes a day at 8 hours, still while having at least half of the day free (do 60 minutes at night, and the other 60 by Noon).  Thereby doing 1200-1400 lines a day.  I have never really buckled down and done more than 8000 lines per pay period, so it will be a nice change.  Maybe you can do something like that and have a specific knock off time as was suggested below. 
Working holidays? Out shopping in stores where someone IS working

that holiday you refuse to work?  Grocery stores, food joints & seems any store is open on holidays and you expect them to be fully staffed, so why shouldn't we?


Yes, I took off for the first time on Christmas day, in 18 years and it was great, but I worked Christmas eve and this whole past weekend.


Someone has to do it!


Hospital. I wish I'd never left my hospital job.
They'll only take me back if I start off working nights and weekends again at the bottom of the totem pole.
If you work for a hospital - how come no one from the hospital
called you?? Were they in the dark, as well?? How sad, that no one in your hospital communicates with the at home staff.
Somehow working at home translates into not really working
My in-laws are the worst. Whenever they plan something last minute and my husband says that I had to work, they say, "but she works at home!". When I one time mentioned I had a "schedule" and basically punch a clock and work full time, I don't think they believed me. They will sometimes call mid-day during the week if they are in the area to see if I want to go for lunch, etc! The best is, my husband doesn't make all that much money, so where is it coming from, the money fairy? I am ready to strangle someone! So I know how you feel and I'm sorry it upset you. You are not alone.
I daydream about NOT working while I'm working.

There are so many other things I need and want to get done.  I've been working way too hard lately, and summer is just slipping by again.  Well, I'm outty.


If one's biz is small I do not think you can....nm